As the discussion continues with regard to the role of physician extenders hospitals and medical practices will need to determine the best way to go forward. In some circumstances it will be appropriate for primary care as well as specialty practices to continue to include physician extenders within the four walls of the practice. The same will be true in hospital settings with physician extenders providing certain care on behalf of the institution. In other cases it will be clear that, based on state law and local economic conditions, physician extenders will begin and continue practicing more and more on their own. Being able to make the financial decisions and calculations in advance, as well as the strategic decisions in understanding and implementing new and continually changing relationships will enhance the financial success going forward.

The United States has a shortage of primary care doctors, and some policymakers want to fill the gap by expanding the role of nurse practitioners. But the two professions are engaged in a turf war over who can do the job better, a new survey finds. The results of the survey were reported in the May 16 issue of the New England Journal of Medicine. Experts expected some controversy, but said they were surprised at how far apart doctors and nurse practitioners were in their opinions. The nearly 1,000 doctors and nurse practitioners surveyed were most divided on the question of who gives the higher quality of care: Two-thirds of physicians said if a doctor and nurse practitioner provided the same service, the doctor would do it better.

Perhaps predictably, few nurse practitioners agreed with that. And although 82 percent of nurse practitioners felt nurse practitioners should lead their own practices, only 17 percent of doctors did. And while 64% of NPs said they should receive the same pay as physicians for the same care, only 4% of physicians agreed.

So what does all of that mean? Experts said the divide between doctors and nurse practitioners has implications for how U.S. health care looks in the future. Based on a number of studies, Americans' demand for primary care providers is straining the limited supply.

One survey found that 16 percent of U.S. adults have to wait at least six days for a doctor's appointment when they have a health problem that needs attention. And experts expect the shortage to worsen with health care reform, which will extend insurance coverage to about 30 million more Americans. Some policymakers think nurse practitioners offer a way to address the problem.
(HealthDay)